OPERATIONAL IMPROVEMENT OF GYNECOLOGIC LAPAROSCOPIC OPERATING-ROOM SERVICES - AN INTERNAL REVIEW

'Background: To reorganize reusable laparoscopic instrumentation to pr omote instrument accessibility, minimize instrument breakage, eliminat e infrequently used instruments on permanent trays, and help control m aintenance costs. Technique: The Robert Wood Johnson University Hospit al Gynecologic Steering Committee evaluated during a 5-month period th e storage, use, and maintenance of gynecologic laparoscopic instrument sets used in the surgical suite. Acting on this data, the committee o versaw the following changes. infrequently used instruments were remov ed from permanent trays and separately packaged. Two types of gynecolo gic laparoscopy trays were prepared: one for laparoscopic bilateral tu bal ligations and one for both diagnostic and operative laparoscopy. A double-decker compartmentalized tray in which instruments were steril ized and stored replaced the extant single-layer ones in which instrum ents were stacked on each other. To facilitate instrument identificati on and function, a surgical manual was compiled with photographs of ea ch instrument and a description of its use. Experience: After implemen tation of these changes, maintenance and sterilization costs for a 10- month period were compared with those for the previous 10 months. Ther e was a savings of $13,889. The ratio of total costs divided by number of cases performed during the two study periods was also compared. Th ere was a savings of $31 per case. Conclusion: Savings were achieved b y reorganizing this operating room's handling of reusable gynecologic laparoscopy equipment. By eliminating infrequently used instruments fr om the permanent trays and by using a double decker compartmentalized tray that was used during surgery, sterilization, and storage, both st erilization costs and maintenance costs were reduced. (Obstet Gynecol 1998;92: 142-4. (C) 1998 by The American College of Obstetricians and Gynecologists.).